title: Characteristics of patients with chronic unexplained nausea and vomiting and normal gastric emptying.
abstract: OBJECTIVE
  Chronic nausea and vomiting with normal gastric emptying is a poorly understood syndrome; we analyzed its characteristics.
  
  
  METHODS
  We collected and analyzed data from 425 patients with chronic nausea and vomiting, enrolled at 6 centers by the Gastroparesis Clinical Research Consortium in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry.
  
  
  RESULTS
  Among the patients, 319 (75%) had delayed emptying, defined by the results of a standardized, low-fat meal, and 106 had normal gastric emptying. Patients with or without delayed emptying did not differ in age, sex, or race, although those with normal gastric emptying were less likely to be diabetic. Symptom severity indexes were similar between groups for nausea, retching, vomiting, stomach fullness, inability to complete a meal, feeling excessively full after meals, loss of appetite, bloating, and visibly larger stomach. There were no differences in health care utilization, quality of life indexes, depression, or trait anxiety scores. However, state anxiety scores were slightly higher among patients with delayed gastric emptying. Total gastroparesis cardinal symptom index scores were not correlated with gastric retention after 2 or 4 hours in either group. Patients with the syndrome were not adequately captured by the stand-alone criteria for the Rome III diagnoses of chronic idiopathic nausea and functional vomiting. With rare exceptions, the diagnosis remained stable after a 48-week follow-up period.
  
  
  CONCLUSIONS
  Patients with nausea and vomiting with normal gastric emptying represent a significant medical problem and are, for the most part, indistinguishable from those with gastroparesis. This syndrome is not categorized in the medical literature--it might be a separate clinical entity.
authors.affiliation: Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, California 94305-5187, USA. Pasricha@stanford.edu
authors.forename: Pankaj J
authors.initials: PJ
authors.lastname: Pasricha
authors.forename: Ryan
authors.initials: R
authors.lastname: Colvin
authors.forename: Katherine
authors.initials: K
authors.lastname: Yates
authors.forename: William L
authors.initials: WL
authors.lastname: Hasler
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
authors.forename: Aynur
authors.initials: A
authors.lastname: Unalp-Arida
authors.forename: Linda
authors.initials: L
authors.lastname: Nguyen
authors.forename: Gianrico
authors.initials: G
authors.lastname: Farrugia
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Koch
authors.forename: Henry P
authors.initials: HP
authors.lastname: Parkman
authors.forename: William J
authors.initials: WJ
authors.lastname: Snape
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.forename: James
authors.initials: J
authors.lastname: Tonascia
authors.forename: Frank
authors.initials: F
authors.lastname: Hamilton
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000175:diagnosis* / Q000453:epidemiology*; D014839:Vomiting / Q000175:diagnosis* / Q000453:epidemiology*